前列腺素E2在突出腰椎间盘中的表达及其与坐骨神经痛的关系

Prostaglandin E2 expression in herniated lumbar disc and its relationship with sciatica

目的探讨前列腺素(PG)E2在突出腰椎间盘组织中的表达及其在坐骨神经痛发病机制中的作用。方法 42个突出椎间盘标本取自42例腰椎间盘突出并有坐骨神经放射性疼痛症状的手术治疗患者,其中膨隆型12例,破裂型15例,游离型15例,取材部位为紧贴神经根突入椎管的椎间盘组织(A部位)和椎间隙内残存的椎间盘组织(B部位)。术前采用视觉模拟评分(VAS)对所有患者坐骨神经痛严重程度进行评分。应用酶联免疫吸附试验(ELISA)检测PGE2含量。结果 A部位PGE2含量自膨隆型、破裂型至游离型逐渐升高,差异有显著性(P<0.01);A部位PGE2含量高于B部位(P<0.01);PGE2含量与患者坐骨神经痛VAS评分存在明显相关性(r=0.848,P<0.01)。结论 PGE2参与了腰椎间盘退变、突出的发病机制,PGE2含量与坐骨神经痛程度呈正相关性。

Objective To study the expression of prostaglandin （PG） E2 in herniated lumbar disc and its relationship to sciatica. Methods Fifty-two herniated lumbar discs were taken from 42 patients with sciatica. Twelve discs in which were inflation type, 15 extrusion type and 15 sequestration type. The herniated disc tissue was obtained from the herniated tissue or separate fragment （Zone A） and the remainder of nucleus pulposus in lumbar intervertebral disc （Zone B）. Before surgery, the sciatica was evaluated by the visual analogue scale （VAS）. The PGE2 expression was measured with enzyme linked immunosorbent assay （ELISA）. Results The PGE2 expression increased significantly from inflation, extrusion to sequestration type at Zone A （P〈0.01）. The PGE2 expression was higher at Zone A than at Zone B （P〈0. 01）. A positive correlation was present between the PGE2 expression and the VAS of sciatica （r = 0. 848, P〈0. 01）. Conclusions PGE2 involve in the pathogenesis of lumbar disc degeneration and herniation, PGE2 levels closely relate to the degree of sciatica.